The South Beach Diet Supercharged: Faster Weight Loss and Better Health for Life (2 page)

The South Beach Diet was always intended to be more than just a diet. In fact, it was originally developed to help my cardiac and diabetes patients lose weight in order to prevent heart attacks and strokes. As a cardiologist, I have always felt that the South Beach Diet is less about dieting and more about living a long, healthy, and active life. I wrote the original book in 2003 because I wanted to help change the way America eats. Now I have a new goal: I want to change the way America
lives
, not only by helping people eat healthfully and lose weight, if necessary, but also by helping them become more fit. We must begin to overcome the poor eating habits and sedentary lifestyle that are making us fatter and sicker with each passing year.

Over the past several decades, we have witnessed an unexpected epidemic of obesity in this country. One-third of American adults over age 20 are obese, and two-thirds of us are overweight. The number of seriously overweight children has tripled. Moreover, statistics show that 51 percent of Americans don’t engage in any kind of regular physical activity. The results have been catastrophic.

This epidemic of obesity is causing an array of health problems that is much broader than we doctors ever imagined. Beyond the cosmetic concerns that pervade our culture, the list of real problems arising from our toxic lifestyle is getting ever longer. A partial list includes—and you may want to sit down for this—heart attack, stroke, prediabetes, diabetes, many types of cancer, Alzheimer’s disease, macular degeneration, arthritis, osteoporosis, psoriasis, acne, depression, and attention deficit disorders. And this is just a sampling.

It also appears that if we do not reverse the health course that we are on, the cost in human and economic terms will reach crisis proportions. Our poor diet and sedentary lifestyle are already exacting a steep toll in terms of mortality and money. They’re responsible for an estimated 300,000 premature deaths every year and $90 billion in health-care costs, but I believe the real costs are much higher. And as the baby boom generation gets older, these health costs will likely continue to soar.

Sadly, this is not only an American problem. Just as our sedentary, fast-food lifestyle is being exported around the world, so are the attendant health problems. The good news is that now that we better understand what’s happening to us, we can start to create solutions.

A Sedentary Nation

In order to develop strategies to halt and reverse the epidemic of obesity, we must be aware of the trends that have gradually but inexorably brought us to the crisis situation we are in today. I have found in my practice that by putting patients’ current problems into a context they can understand, they can more easily become cooperative partners in moving toward solutions. Perhaps because I was a history major (not all doctors are bio majors), I also find that tracing today’s health problems back to their original roots is fascinating.

The truth is that while our bad diet and unhealthy lifestyle have been many decades in the making, the toxic changes in the way we live have really accelerated in recent years. Our DNA is designed to live, eat, and exercise the way our hunter-gatherer ancestors did, and it hasn’t changed substantially since that time. But we no longer live in the wild. We don’t have famine in this country to keep us thin. We no longer burn calories hunting and gathering our food.

On top of that, a completely sedentary lifestyle has gradually crept in, invention by incredible invention. Due to the march of technology, we sit in front of computers both at work and at home. Machines and gadgets lift, move, and carry things for us. We communicate by e-mail, and many of us don’t even walk down the hall to chat with colleagues as often as we used to! While studies document how much less physical exertion we’re doing, we really don’t need research studies to appreciate the trend. All we have to do is look around.

The preponderance of labor-saving devices, from tractors and forklifts to remote controls and the personal computer, has had a major impact on the number of calories we expend daily at home and at work. These devices have also had devastating effects on our muscles, bones, tendons, and ligaments. Sitting bent over at a computer for most of the day is simply not good for our health. In
Chapter 5
, “Boomeritis: The New Epidemic!” I talk about these evolving physical problems and their solutions. And in Part II of the book, I present the South Beach Supercharged Fitness Program. Not only will this 20-minute-a-day program help you burn more calories even when you’re not working out, it will also strengthen the key core muscles in your abdomen, back, pelvis, and hips. It’s your core muscles that help you avoid the back pain and other muscle problems that so often result from our sedentary lives.

Missing Our Nutrients

Our unhealthy lifestyle is made even worse by our poor diet. Since we began growing fields of grain about 10,000 years ago and developed the ability to cultivate fruits and vegetables, the nutritional content of our foods has seriously deteriorated. This is because we tend to breed plants for hardiness, taste, and aesthetics, not nutrients. Today, the fruits and vegetables we find in most supermarkets are larger, sweeter, and better-looking than those our ancestors gathered. The problem is that they also have less fiber and fewer vitamins, minerals, and other nutrients than is optimal for our general health—not to mention our waistlines. Luckily, more and more Americans are embracing organic foods, heirloom fruits and vegetables, and sustainable farming methods, all trends that are bringing food back to its more natural and nutritious state. In
Chapter 7
, “Supercharged Foods for Better Health,” I recommend some foods with powerful nutritional benefits that can help you stay healthy and avoid the host of chronic and degenerative diseases currently affecting so many of us.

A Nation Overprocessed

Beyond our desire to cultivate and produce food almost exclusively to please our tastebuds, other social and technological trends have affected our food supply for the worse. A few generations ago, our great grandparents walked to local markets on a daily basis to buy whatever produce they didn’t grow themselves as well as fresh bread and other food for their families’ next meals. They could only travel to local markets and take home what they were able to carry. With the advent of the automobile and the home refrigerator, however, it became possible to travel farther to shop, and people could take home enough food to feed their families for a week or two. But for that to be possible, foods had to have longer shelf lives. This led to supermarkets and to food processing, which, unfortunately, removed important nutrients while adding substances like sodium and trans fats to prevent spoilage. In a sense, we began digesting our food in factories instead of in our intestines.

It’s only now that we are appreciating the deleterious effects these technological “advances” have had on our weight and on our health. In
Chapter 3
, “A Diet You Can Live With…For Life,” I discuss the health and character of a Mediterranean society that thrived without many of our modern advances, and I show you how we can learn from this remarkable example.

We Must Act Now

If you’re like me, you find how we got into this sad state not only depressing but scary. But there is hope if we take action today. Because we finally understand so much of what has gone wrong, we can use our advanced technologies to turn things around. We now know that our increasing waistlines, poor physical fitness, and worsening health are not different problems but, rather, part of the same problem. We now know that what’s good for our waistlines is also good for our hearts, our brains, and our general health.

We must ask the food industry, including traditional and fast-food restaurants, to help make healthy food more convenient and convenient food healthier. We must supply our schoolchildren with nutrient-rich meals and make nutrition education and physical education integral parts of our schools’ curricula. We must reinstate the family table and, despite our busy schedules, try to provide fresh foods for our children on a regular basis. We must also create communities and workplaces where good food and exercise opportunities are readily available. These steps will make for a healthier, happier, more motivated, and more productive America. I guarantee it.

In the chapters that follow, I explain the lifelong benefits of adopting a healthy diet and fitness program. And in Parts II and III, I offer the specifics on how to get there. Whether you have 10 pounds, 100 pounds, or no weight to lose, whether you are active or inactive, helping you to become healthy and fit—for life—is the mission of this book. So read on and learn more. We can beat the epidemic of obesity in this country. And we can all become part of the solution.

Recently, an Associated Press story about the New York City subway system caught my eye. According to subway officials, a leading cause of subway delays is crash dieters who faint on the platform or on the train. That’s right—crash dieters who pass out and require medical help are a top cause of transit delays. Clearly, these folks are not eating properly, and they’re certainly not following the South Beach Diet!

On the three phases of the South Beach Diet, you will eat three meals a day and at least two snacks. You will eat until you are pleasantly full, and you will not walk around feeling dizzy or hungry. We don’t want you to skip meals or snacks. You’ll be eating satisfying portions of real food, including nutrient-rich, high-fiber carbohydrates (vegetables, fruits, and whole grains); lean sources of protein; good unsaturated fats; and low-fat dairy. You can eat dessert on even the strictest phase of the diet (in fact, we recommend it) and enjoy an occasional glass or two of wine with a meal after the first 2 weeks. South Beach dieters do not faint from lack of food on the subway, on the street, or anywhere else.

The goals of the South Beach Diet are to help you lose weight safely and stay healthy and fit for the rest of your life—and never walk around feeling famished and light-headed.

The South Beach Diet is not a high-protein, low-carbohydrate diet, nor is it a low-fat diet. It is a nutritionally sound diet that consists of a wide variety of wholesome foods and teaches you how to make better food choices for life.

Choose the Good Carbs

Do you know the difference between a good carbohydrate and a bad one? Many of my patients didn’t until we published our original diet book 5 years ago. In fact, until fairly recently, even many medical professionals did not know much about how carbohydrates differ. For instance, it turns out that fiber plays a very important role in what makes a carbohydrate good.

The concept of dietary fiber relating to disease was first introduced by Denis Burkitt, MD, a British army surgeon who served in Africa in the 1960s, but its role in nutrition did not become widely appreciated until the early 1980s. That’s when David Jenkins, MD, of the University of Toronto, introduced the concept of the glycemic index, a method of classifying carbohydrates based on their potential to raise blood sugar levels, which is in part due to the type of starch, sugar, or fiber they contain. (I discuss the glycemic index in more detail in the next chapter.) Additionally, it wasn’t until the last decade that we realized that high-fiber good carbs are also great sources of literally thousands of micronutrients known as phytochemicals, including the antioxidants that are essential for preventing disease and simply keeping us healthy.

When it comes to fiber, it’s important to know that there are two types—soluble and insoluble—and both will help you achieve your weight loss goals. Soluble fiber is found mainly in vegetables, fruits, legumes, barley, oats, and oat bran. It slows down digestion, so food stays in your stomach longer, making you feel satisfied longer. Insoluble fiber is found mainly in wheat, especially in wheat bran and other whole grains. It speeds up the movement of food through your intestines, thereby helping to prevent constipation.

Unfortunately, as I noted in the last chapter, fiber is often removed from grains during processing to produce a smoother texture and to extend the shelf life of breads and other baked goods. Without fiber, processed grains become essentially chains of glucose (sugar) molecules known as starches, which are devoid of nutrients. These starches are rapidly digested and converted into the simple sugars that can cause a sudden spike in blood sugar. In fact, a piece of white bread will raise your blood sugar faster than a teaspoon of table sugar will. That’s why highly processed baked goods and sugary low-fiber cereals are among the worst carbs you can eat.

Let’s say you typically start your day with a bowl of sweetened cereal or a Danish pastry. Your breakfast is largely free of fiber and nutrients and is converted into simple sugars very quickly. When your blood sugar rises, your pancreas (a small, flat organ that lies behind your stomach) responds by producing insulin, the hormone that facilitates the movement of blood sugar and fat from the bloodstream into your cells. This is a crucial step that ensures that the energy you consume in the form of food gets into your body’s tissues, where it is burned, stored, or incorporated into hormones in order to keep you functioning and healthy. But when you consume a meal of nearly pure starch or sugar, your pancreas has to produce more insulin than it normally does. Once that additional insulin kicks in, your blood sugar falls abruptly. While you may feel satisfied and energized for a while, relatively soon after your meal, when the sugar is cleared from your bloodstream, your sugar high rapidly becomes a sugar low. And as your blood sugar drops, you feel tired, cranky, and hungry again.

It’s due to these exaggerated swings in blood sugar that many Americans are walking around much of the time in search of another sugary or starchy snack—a quick fix—to relieve their food cravings. Over time, this cycle will disrupt your metabolism, making you susceptible to a condition called prediabetes, or metabolic syndrome. (I will tell you more about prediabetes in later chapters.) Already some 40 percent of US adults ages 40 to 70 are affected by this condition, which, if left untreated, can cause an increase in heart attacks and strokes and eventually lead to full-blown diabetes.

Choose the Good Fats

More than a decade ago, when I first began suggesting to my heart patients that they should eat more good fats, it was tantamount to committing medical heresy. Today, nutrition experts unanimously agree that good fats are important. This is great news, especially for people who have suffered on very low-fat diets that left them feeling unsatisfied. In fact, diets that severely limit fat have proven very difficult to stay on. We need good fats because they’re essential for building cell membranes; for nerve, heart, and brain health (fats compose 60 percent of the brain); and for nearly all of the body’s basic functions. In addition, fats slow the digestion of carbohydrates and make food taste better, helping you feel satisfied. However, you do have to be careful about which fats you consume. Just as all carbohydrates are not the same, all fats are not the same. Some are good, some are bad, and some are really terrible.

Good fats are the unsaturated fatty acids our bodies need to survive. Unsaturated fats are either monounsaturated or polyunsaturated. Monounsaturated fats can be found mainly in olive, peanut, avocado, and canola oils. There are two types of polyunsaturated fats—omega-3s and omega-6s. Omega-3s are found in some nuts; flaxseed and other seeds; and all seafood, especially fatty cold-water fish such as salmon, tuna, sardines, and herring. Omega-6 fats are found in corn, safflower, and sesame oils and also in grains. Both omega-3s and omega-6s are called essential fatty acids because they are required by the body and must be obtained through food sources or supplementation.

Omega-6 fats are dependent on interactions with omega-3s for their optimal health benefits, but omega-6s are considered good fats only when consumed in moderation and in proper proportion with omega-3s. A normal ratio of omega-6s to omega-3s in a healthy diet should be about 2–4:1. Currently, most Americans’ ratios are more like 15–17:1, largely because we eat a lot of omega-6-rich oils and a lot of grain-fed beef in this country, and grains contain omega-6s. (Grass-fed cattle and wild game, which eat a more natural diet, have relatively more omega-3s.) When too many omega-6 fats are consumed, they tend to be proinflammatory, whereas omega-3 fats are anti-inflammatory. Because we are getting too many omega-6s and not enough omega-3s, as a society we have, in a sense, become hyperinflamed. And, as more studies are showing, this constant state of inflammation can cause or exacerbate a range of health problems, from heart attack and cancer to Alzheimer’s disease.

Although I don’t generally recommend dietary supplements (I prefer that you get your nutrients from whole foods), I make an exception when it comes to omega-3s. In fact, to make up the shortfall, I recommend a fish-oil supplement for most people, especially those who don’t eat fish at least twice weekly.

The two active ingredients to look for in omega-3 or fish-oil supplements are EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). If you read the supplement label, you will see the amount of these nutrients listed in milligrams (mg). You should take between 1,000 and 2,000 milligrams of EPA and DHA daily, with the approval of your doctor. For some conditions, such as a severe elevation in triglycerides, higher doses are recommended. Interestingly, DHA is present in large quantities in the brain and has been added to many brands of infant formula since 2002.

We do need to be a little careful, however, even with the good fats. As good as they are, they are also calorie dense and should be consumed judiciously during all phases of the South Beach Diet. I suggest that you limit added oils to approximately 2 tablespoons per day (no, you don’t have to eat your salads dry!) and limit nuts to about ¼ cup a day. While many nuts do contain good fats, it’s too easy to unconsciously eat way too many.

Avoid the Bad Fats

Bad fats include saturated fats (often referred to as animal fats), which are found primarily in fatty cuts of beef, lamb, and pork; in poultry with the skin; and in full-fat dairy products. There are also plant sources of saturated fats, including coconut, palm, and palm kernel oils, but the jury is still out on how bad they are. In fact, research suggests that some of these plant oils may have health benefits. The
really
bad fats are trans fats, which are created when manufacturers add hydrogen to vegetable oil—a process called hydrogenation—to increase the shelf life and stability of foods. Trans fats can be found in stick margarines (but not in most soft tub or liquid margarines), vegetable shortenings, foods fried in hydrogenated oils, and many packaged snack foods containing hydrogenated or partially hydrogenated oils.